The History of PACE

Using a capitated payment system, PACE programs are able to provide the entire continuum of care and services to older adults with chronic care needs while maintaining their independence at home for as long as possible.

Philosophy

The Program of All-Inclusive Care for the Elderly (PACE®) model is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.

PACE serves individuals who are age 55 or older, certified by their state to need nursing home care, able to live safely in the community at the time of enrollment, and live in a PACE service area. While all PACE participants must be certified to need nursing home care to enroll in PACE, only about 7 percent of PACE participants nationally reside in a nursing home. If a PACE enrollee needs nursing home care, the PACE program pays for it and continues to coordinate the enrollee's care.

Services

Delivering all needed medical and supportive services, a PACE program is able to provide the entire continuum of care and services to seniors with chronic care needs while maintaining their independence in their home for as long as possible. Services include the following:

adult day care that offers nursing; physical, occupational and recreational therapies; meals; nutritional counseling; social work and personal care;

medical care provided by a PACE physician familiar with the history, needs and preferences of each participant;

History

The PACE model of care can be traced to the early 1970s, when the Chinatown-North Beach community of San Francisco saw the pressing needs for long-term care services by families whose elders had immigrated from Italy, China and the Philippines. William Gee, DDS, a public health dentist, headed the committee that hired Marie-Louise Ansak in 1971 to investigate solutions. Along with other community leaders, they formed a nonprofit corporation called On Lok Senior Health Services to create a community-based system of care. On Lok is Cantonese for "peaceful, happy abode."

1971

William Gee, DDS, and two others execute articles of incorporation for the nonprofit Chinatown-North Beach Health Care Planning and Development Corporation (later renamed On Lok Senior Health Services) and retain Marie-Louise Ansak to study the feasibility of building a nursing home in the community. She finds a nursing home would be financially infeasible and culturally inappropriate. Instead, she obtains funding to train health care workers in cooperation with the University of California San Francisco. She also outlines a comprehensive system of care combining housing and all necessary medical and social services based on the British day hospital model.

1973

On Lok opens one of the nation’s first adult day centers in San Francisco.